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Hypothyroidism after primary surgical treatment for laryngeal and hypopharyngeal cancer

Year 2008, Volume: 18 Issue: 3, 125 - 130, 25.06.2008

Abstract

Objectives: We investigated the incidence of hypothyroidism after treatment of laryngeal or hypopharyngeal cancer LHC , and evaluated its relationship with treatment modalities. Patients and Methods: Thyroid functions of 42 patients 41 males, 1 female; mean age 58 years; range 35 to 81 years undergoing surgical treatment with 74% or without adjuvant radiotherapy for LHC were prospectively evaluated preoperatively, on the 15th day, and in the sixth month postoperatively. The results were compared in relation to the treatment methods employed. Results: The overall incidence of post-treatment hypothyroidism was 23.8%. Five patients had hypothyroidism in the early postoperative period, and this number increased to 10 after six months. All patients with hypothyroidism had undergone total laryngectomy with bilateral neck dissection, followed by radiotherapy. A significantly higher incidence of hypothyroidism was associated with total laryngectomy, bilateral neck dissection, level VI dissection, partial or bilateral thyroidectomy, adjuvant radiotherapy, and upper mediastinal radiothrapy. Conclusion: The incidence of post-treatment hypothyroidism is not rare in LHC patients, requiring long-term monitoring of thyroid functions to prevent associated morbidities.

References

  • Sinard RJ, Tobin EJ, Mazzaferri EL, Hodgson SE, Young DC, Kunz AL, et al. Hypothyroidism after treatment for nonthyroid head and neck cancer. Arch Otolaryngol Head Neck Surg 2000;126:652-7.
  • Aimoni C, Scanelli G, D’agostino L, Pastore A. Thyroid function studies in patients with cancer of the larynx: preliminary evaluation. Otolaryngol Head Neck Surg 2003;129:733-8.
  • Tami TA, Gomez P, Parker GS, Gupta MB, Frassica DA. Thyroid dysfunction after radiation therapy in head and neck cancer patients. Am J Otolaryngol 1992; 13:357-62.
  • Vrabec DP, Heffron TJ. Hypothyroidism following treatment for head and neck cancer. Ann Otol Rhinol Laryngol 1981;90(5 Pt 1):449-53.
  • Shafer RB, Nuttall FQ, Pollak K, Kuisk H. Thyroid function after radiation and surgery for head and neck cancer. Arch Intern Med 1975;135:843-6.
  • Gal RL, Gal TJ, Klotch DW, Cantor AB. Risk factors associated with hypothyroidism after laryngectomy. Otolaryngol Head Neck Surg 2000;123:211-7.
  • Mini S, Dori S, Horowitz Z, Bedrin L, Peleg M, Wolf M, et al. Pretreatment prevalence of hypothyroidism in patients with head and neck carcinoma. Cancer 2001;92:1512-5.
  • Lavelle RJ. Thyroid function after radiotherapy and total laryngectomy in the treatment of carcinoma of the larynx. Ann Otol Rhinol Laryngol 1971;80:593-8.
  • Mercado G, Adelstein DJ, Saxton JP, Secic M, Larto MA, Lavertu P. Hypothyroidism: a frequent event after radiotherapy and after radiotherapy with che- motherapy for patients with head and neck carcinoma. Cancer 2001;92:2892-7.
  • de Jong JM, van Daal WA, Elte JW, Hordijk GJ, Frolich M. Primary hypothyroidism as a complication after treatment of tumours of the head and neck. Acta Radiol Oncol 1982;21:299-303.
  • Colevas AD, Read R, Thornhill J, Adak S, Tishler R, Busse P, et al. Hypothyroidism incidence after multi- modality treatment for stage III and IV squamous cell carcinomas of the head and neck. Int J Radiat Oncol Biol Phys 2001;51:599-604.
  • Posner MR, Ervin TJ, Miller D, Fabian RL, Norris CM Jr, Weichselbaum RR, et al. Incidence of hypo- thyroidism following multimodality treatment for advanced squamous cell cancer of the head and neck. Laryngoscope 1984;94:451-4.
  • Cinar U, Yigit O, Alkan S, Uslu B, Topuz E, Unsal O, et al. The effect of laryngectomy and postoperative radiotheraphy on thyroid gland functions. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2003;10:226-30.
  • Buisset E, Leclerc L, Lefebvre JL, Stern J, Ton-Van J, Gosselin P, et al. Hypothyroidism following combined treatment for hypopharyngeal and laryngeal carci- noma. Am J Surg 1991;162:345-7.
  • Liening DA, Duncan NO, Blakeslee DB, Smith DB. Hypothyroidism following radiotherapy for head and neck cancer. Otolaryngol Head Neck Surg 1990;103:10-3.
  • Tell R, Lundell G, Nilsson B, Sjodin H, Lewin F, Lewensohn R. Long-term incidence of hypothyroid- ism after radiotherapy in patients with head-and-neck cancer. Int J Radiat Oncol Biol Phys 2004;60:395-400.
  • Garcia-Serra A, Amdur RJ, Morris CG, Mazzaferri E, Mendenhall WM. Thyroid function should be moni- tored following radiotherapy to the low neck. Am J Clin Oncol 2005;28:255-8.

Larenks ve hipofarenks kanserlerinde primer cerrahi tedavi sonrası hipotiroidizm

Year 2008, Volume: 18 Issue: 3, 125 - 130, 25.06.2008

Abstract

Amaç: Larenks ve hipofarenks kanserlerinde LHK tedavi sonrası hipotiroidi görülme sıklığı araştırıldı ve uygulanan tedavi yöntemi ile hipotiroidi sıklığı arasındaki ilişki incelendi.Hastalar ve Yöntemler: Cerrahi tedavi gören LHK’li 42 hastanın tiroid fonksiyonları ileriye dönük olarak, tedavi öncesinde, ameliyattan 15 gün ve altı ay sonra değerlendirildi. Hastaların %74’üne cerrahiden sonra adjuvan radyoterapi uygulandı. Sonuçlar uygulanan tedavi yöntemleriyle karşılaştırmalı olarak değerlendirildi.Bulgular: Tedavi sonrası genel hipotiroidi oranı %23.8 bulundu. Ameliyat sonrası erken dönemde beş hastada hipotiroidi görülürken, altı ay sonra bu sayı 10’a yükseldi. Hipotiroidi gelişen tüm hastalarda total larenjektomi, iki taraflı boyun diseksiyonu ve ameliyat sonrası radyoterapi uygulanmıştı. Total larenjektomi, iki taraflı boyun diseksiyonu, seviye VI diseksiyon, kısmi veya iki taraflı tiroidektomi, adjuvan radyoterapi ve üst mediastinal radyoterapi uygulamalarının hipotiroidi gelişme sıklığı ile anlamlı ilişki gösterdiği saptandı.Sonuç: Tedavisi sonrası hipotiroidi sıklığı LHK’li hastalarda yüksektir. Hipotiroidi morbiditesinden korunmak için, bu hastalar tiroid fonksiyon testleri ile tedavi sonrasında uzun süreli olarak izlenmelidir

References

  • Sinard RJ, Tobin EJ, Mazzaferri EL, Hodgson SE, Young DC, Kunz AL, et al. Hypothyroidism after treatment for nonthyroid head and neck cancer. Arch Otolaryngol Head Neck Surg 2000;126:652-7.
  • Aimoni C, Scanelli G, D’agostino L, Pastore A. Thyroid function studies in patients with cancer of the larynx: preliminary evaluation. Otolaryngol Head Neck Surg 2003;129:733-8.
  • Tami TA, Gomez P, Parker GS, Gupta MB, Frassica DA. Thyroid dysfunction after radiation therapy in head and neck cancer patients. Am J Otolaryngol 1992; 13:357-62.
  • Vrabec DP, Heffron TJ. Hypothyroidism following treatment for head and neck cancer. Ann Otol Rhinol Laryngol 1981;90(5 Pt 1):449-53.
  • Shafer RB, Nuttall FQ, Pollak K, Kuisk H. Thyroid function after radiation and surgery for head and neck cancer. Arch Intern Med 1975;135:843-6.
  • Gal RL, Gal TJ, Klotch DW, Cantor AB. Risk factors associated with hypothyroidism after laryngectomy. Otolaryngol Head Neck Surg 2000;123:211-7.
  • Mini S, Dori S, Horowitz Z, Bedrin L, Peleg M, Wolf M, et al. Pretreatment prevalence of hypothyroidism in patients with head and neck carcinoma. Cancer 2001;92:1512-5.
  • Lavelle RJ. Thyroid function after radiotherapy and total laryngectomy in the treatment of carcinoma of the larynx. Ann Otol Rhinol Laryngol 1971;80:593-8.
  • Mercado G, Adelstein DJ, Saxton JP, Secic M, Larto MA, Lavertu P. Hypothyroidism: a frequent event after radiotherapy and after radiotherapy with che- motherapy for patients with head and neck carcinoma. Cancer 2001;92:2892-7.
  • de Jong JM, van Daal WA, Elte JW, Hordijk GJ, Frolich M. Primary hypothyroidism as a complication after treatment of tumours of the head and neck. Acta Radiol Oncol 1982;21:299-303.
  • Colevas AD, Read R, Thornhill J, Adak S, Tishler R, Busse P, et al. Hypothyroidism incidence after multi- modality treatment for stage III and IV squamous cell carcinomas of the head and neck. Int J Radiat Oncol Biol Phys 2001;51:599-604.
  • Posner MR, Ervin TJ, Miller D, Fabian RL, Norris CM Jr, Weichselbaum RR, et al. Incidence of hypo- thyroidism following multimodality treatment for advanced squamous cell cancer of the head and neck. Laryngoscope 1984;94:451-4.
  • Cinar U, Yigit O, Alkan S, Uslu B, Topuz E, Unsal O, et al. The effect of laryngectomy and postoperative radiotheraphy on thyroid gland functions. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2003;10:226-30.
  • Buisset E, Leclerc L, Lefebvre JL, Stern J, Ton-Van J, Gosselin P, et al. Hypothyroidism following combined treatment for hypopharyngeal and laryngeal carci- noma. Am J Surg 1991;162:345-7.
  • Liening DA, Duncan NO, Blakeslee DB, Smith DB. Hypothyroidism following radiotherapy for head and neck cancer. Otolaryngol Head Neck Surg 1990;103:10-3.
  • Tell R, Lundell G, Nilsson B, Sjodin H, Lewin F, Lewensohn R. Long-term incidence of hypothyroid- ism after radiotherapy in patients with head-and-neck cancer. Int J Radiat Oncol Biol Phys 2004;60:395-400.
  • Garcia-Serra A, Amdur RJ, Morris CG, Mazzaferri E, Mendenhall WM. Thyroid function should be moni- tored following radiotherapy to the low neck. Am J Clin Oncol 2005;28:255-8.
There are 17 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Özlem Kaya Turgut This is me

Levent Erişen This is me

Hamdi Hakan Coşkun This is me

Oğuz Basut This is me

Selçuk Onart This is me

İbrahim Hızalan This is me

Publication Date June 25, 2008
Published in Issue Year 2008 Volume: 18 Issue: 3

Cite

APA Kaya Turgut, Ö., Erişen, L., Coşkun, H. H., Basut, O., et al. (2008). Hypothyroidism after primary surgical treatment for laryngeal and hypopharyngeal cancer. The Turkish Journal of Ear Nose and Throat, 18(3), 125-130.
AMA Kaya Turgut Ö, Erişen L, Coşkun HH, Basut O, Onart S, Hızalan İ. Hypothyroidism after primary surgical treatment for laryngeal and hypopharyngeal cancer. Tr-ENT. June 2008;18(3):125-130.
Chicago Kaya Turgut, Özlem, Levent Erişen, Hamdi Hakan Coşkun, Oğuz Basut, Selçuk Onart, and İbrahim Hızalan. “Hypothyroidism After Primary Surgical Treatment for Laryngeal and Hypopharyngeal Cancer”. The Turkish Journal of Ear Nose and Throat 18, no. 3 (June 2008): 125-30.
EndNote Kaya Turgut Ö, Erişen L, Coşkun HH, Basut O, Onart S, Hızalan İ (June 1, 2008) Hypothyroidism after primary surgical treatment for laryngeal and hypopharyngeal cancer. The Turkish Journal of Ear Nose and Throat 18 3 125–130.
IEEE Ö. Kaya Turgut, L. Erişen, H. H. Coşkun, O. Basut, S. Onart, and İ. Hızalan, “Hypothyroidism after primary surgical treatment for laryngeal and hypopharyngeal cancer”, Tr-ENT, vol. 18, no. 3, pp. 125–130, 2008.
ISNAD Kaya Turgut, Özlem et al. “Hypothyroidism After Primary Surgical Treatment for Laryngeal and Hypopharyngeal Cancer”. The Turkish Journal of Ear Nose and Throat 18/3 (June 2008), 125-130.
JAMA Kaya Turgut Ö, Erişen L, Coşkun HH, Basut O, Onart S, Hızalan İ. Hypothyroidism after primary surgical treatment for laryngeal and hypopharyngeal cancer. Tr-ENT. 2008;18:125–130.
MLA Kaya Turgut, Özlem et al. “Hypothyroidism After Primary Surgical Treatment for Laryngeal and Hypopharyngeal Cancer”. The Turkish Journal of Ear Nose and Throat, vol. 18, no. 3, 2008, pp. 125-30.
Vancouver Kaya Turgut Ö, Erişen L, Coşkun HH, Basut O, Onart S, Hızalan İ. Hypothyroidism after primary surgical treatment for laryngeal and hypopharyngeal cancer. Tr-ENT. 2008;18(3):125-30.